OpenAI. (2025) Abstract illustration of health-care marketplace fraud. ChatGPT (Dec 4, 2025 version).
Yesterday, a new preliminary report by the Government Accountability Office (GAO) exposed rampant waste, fraud, and abuse in Affordable Care Act (ACA) marketplace plans, specifically regarding premium subsidies.
With these Obamacare subsidies expiring at the end of the year, Democrats have insisted on extension and, thus, an expansion of Obamacare itself.
Not only did GAO’s analysis find improper use of SSNs to receive Obamacare subsidies, but they also found thousands of dead people receiving tax dollars and, shockingly, every fake identity created by GAO received subsidized ACA coverage.
The GAO’s report makes one thing clear – we should not be spending hundreds of billions of taxpayer dollars to fuel systematic failure.
In addition to a broad analysis, the GAO conducted covert operations, creating fictitious identities with fake or never issued social security numbers (SSNs). Below are some of their disturbing findings.
ALL of the fake identities created by the GAO were approved for subsidized ACA coverage.
The GAO created 20 fictitious identities. In late 2024, 100% were approved. Still, in 2025, 18 of the 20 fake identities are receiving subsidized coverage. This proves that marketplaces approved coverage for those who didn’t submit documents and those who submitted fake documents, including fake citizenship eligibility. The monthly subsidies paid to health insurers on behalf of these 20 fake identities is over $12,300 per month.
There has been rampant misuse of SSNs, including a single SSN being used on 125 separate insurance policies.
As the report explains, CMS does not block new applications using the same SSN. To demonstrate how this can be problematic, the report highlights a 2023 example in which one single SSN “was used on applications for over 125 insurance policies totaling over 26,000 days of coverage, the equivalent of 71 years.”
The GAO “could not identify evidence of reconciliation for over $21 billion in APTC for enrollees who provided SSNs to the federal Marketplace for plan year 2023.” Further, GAO identified at least 29,000 SSNs in 2023 and at least 68,000 SSNs in 2024 that were used to receive “more than one year’s worth of insurance coverage with APTC in a single plan year.”
Big insurance companies are collecting subsidies on behalf of at least 58,000 deceased individuals.
The GAO found that 58,000 of the SSNs receiving advanced premium tax credits (APTC) matched Social Security’s death data. This means that roughly $94 million in subsidies were sent to health insurance companies on behalf of deceased individuals. At least 7,000 of these individuals were dead before their coverage began.
Hundreds of thousands of consumers were enrolled without their consent.
The report highlights concern about agent and broker corrupt practices. Specifically, how bad actors are enrolling consumers through the federal Marketplace by falsifying information on their applications. According to CMS, roughly 275,000 individuals filed complaints in an 8-month period regarding being enrolled in a plan or having their plan changed without their consent. Of course, these are the people who noticed.
This mirrors Paragon Health Institute’s research regarding phantom Obamacare enrollees, finding that “a staggering 40 percent of enrollees in 94 percent actuarial value silver plans and bronze plans had no medical claims in 2024.” No doctor visits, services received, or prescriptions filled.
The enhanced Obamacare subsidies have led to widespread fraud. In addition to lax verification, the new ability to have $0 premium plans incentivized the improper enrollment of millions. The Paragon Health Institute estimated that 6.4 million Americans are improperly enrolled in Obamacare exchanges, a number that surged by more than one-quarter from 2024 to 2025. This level of improper enrollment, which is likely an underestimation, will cost taxpayers up to $27 billion this year.
It is abundantly clear that not even the most basic controls are in place to prevent fraud in the federal Marketplace. Taxpayers should not subsidize such failures.
